Recent advances in the diagnosis monkeypox: implications for public health

ABSTRACT

Introduction

Monkeypox virus is a zoonotic double-stranded DNA poxvirus in the genus Orthopoxvirus, family Poxviridae. Until recently, monkeypox was found primarily in Central and West Africa, where the virus had split into Congo Basin and West African clades.

Areas Covered

On 6 May 2022, monkeypox was detected in the United Kingdom and the virus has now been detected in every continent except Antarctica. The current outbreak represents the first documentation of widespread community transmission outside of Africa.

Expert Opinion

On 23 July 2022, the World Health Organization declared monkeypox a public health emergency of international concern and issued a series of guidance and recommendations for governments, health professionals and the public. This manuscript reviews what is known about monkeypox virus, with a focus on recent diagnostics and epidemiologic advances, and explores how recent advances in our understanding of the virus will be used to combat the expanding outbreak.

KEYWORDS:

• Monkeypox
• Orthopoxvirus
• smallpox
• Poxviridae
• Congo basin clade
• West African clade

Article highlights

• The first case of monkeypox in humans was detected in 1970 in the Democratic Republic of the Congo.

• Monkeypox is often mistaken for other viral infections, including varicella, variola, and measles

• Monkeypox symptoms range from systemic illness (fever, headache, myalgias, lethargy) to a maculopapular rash that may initially appear as pimples or blisters on the face, oral or genital mucosa, or the hands, feet, and chest, and may evolve into vesicles that eventually scab.

• Testing capacity for monkeypox is rapidly expanding; the preferred method of diagnosis involves nucleic acid amplification from a direct specimen.

• Processing and testing of monkeypox specimens should be performed in facilities that have recently vaccinated personnel, preferably within the past three years.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.